Abstract:
BACKGROUND AND STUDY AIMS:One reason why many surgeons do not attempt laparoscopic cholangiography is that it is considered to be technically difficult and to produce poor-quality images. PATIENTS AND METHODS:A retrospective comparison was made of twenty randomly selected intraoperative cholangiograms taken during laparoscopic cholecystectomy for each year from 1991 to 1994 (n = 80) by assigning a score (0-4) on the basis of anatomical parameters and radiographic quality. Twenty randomly selected intraoperative cholangiograms taken during open cholecystectomy (OC) were used as controls. RESULTS:The average score for the laparoscopic cholangiograms (LCs) was significantly lower than the average for OC cholangiograms (2.3 vs. 3.4, P< 0.001). In addition, a learning curve was demonstrated, which showed significant improvement in the quality of LCs over the years. Analysis showed that in LCs, only 34 % succeeded in demonstrating the entire biliary tree and only 49% managed to show the extrahepatic duct system. Choledocholithiasis could only be ruled out in 53 % of LC films, compared with 80 % of controls. CONCLUSIONS:Despite an improvement in the quality of laparoscopic cholangiography, it remains inferior to cholangiography during open cholecystectomy. Recommendations are made regarding ways in which improvements could be achieved.
journal_name
Endoscopyjournal_title
Endoscopyauthors
Arul GS,Rooney PS,Gregson R,Steele RJdoi
10.1055/s-1999-13677subject
Has Abstractpub_date
1999-03-01 00:00:00pages
248-52issue
3eissn
0013-726Xissn
1438-8812journal_volume
31pub_type
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